Individual provider Active NPI

Chanda Le'Rae Hall, MD

  • Obstetrics & Gynecology Physician
  • Northport, AL
National Provider Identifier
1083110118
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD.44365 Issued in AL
Practice address
2750 Hospital Dr
Northport, AL 35476-3360
Phone
(205) 339-3039
NPI assigned
Apr 5, 2018
Last updated
Jun 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Obstetrics & Gynecology Physician 207V00000X MD.44365 AL Primary

Addresses

Primary practice location

2750 Hospital Dr
Northport, AL 35476-3360

Mailing address

2750 Hospital Dr
Northport, AL 35476-3360
Phone (205) 339-3039

Other practice location 1

979 E 3rd St Ste C720
Chattanooga, TN 37403-3329
Phone (423) 778-7515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220614000323 AL Practitioner - Obstetrics/Gynecology 8628327087 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Obstetrics and Gynecology of West Alabama PCGroup PAC ID 9436125531, 12 clinicians

Practice addresses (Care Compare)

2750 Hospital Dr
Northport, AL 35476-3360
Phone (205) 339-3039

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.44365ALMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The DCH Health Care Authority CurrentSince Aug 5, 2022 Accepting new patients
Obstetrics and Gynecology of West Alabama PC CurrentSince Aug 1, 2022 Accepting new patients
The DCH Healthcare Authority CurrentSince Aug 5, 2022 Accepting new patients

Locations

2750 Hospital Dr
Northport, AL 35476
Phone (205) 339-3039

809 University Blvd E
Tuscaloosa, AL 35401
Phone (205) 333-4661

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1083110118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 HOSPITAL DR",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354763360",
            "telephone_number": "205-339-3039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 HOSPITAL DR",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354763360",
            "telephone_number": "205-339-3039"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "979 E 3rd St Ste C720",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374033329",
            "country_code": "US",
            "telephone_number": "423-778-7515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALL",
        "first_name": "CHANDA",
        "middle_name": "LE'RAE",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-05",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AL",
            "license": "MD.44365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northport, AL

Sources for this page

Verify at the official NPI Registry.